ສຸຂະພາບ ແລະ ການເດີນທາງ

ເດີນທາງສະບາຍ ສະບາຍ ກັບ ການບິນໄທ

Pre-travel medical examinations

It is recommended that international passengers seek a pre-travel medical examination and advice on vaccinations, safety precautions and information on the current situation at the destination, before and for the duration of the trip.

Well controlled, diabetics can travel by adjusting their treatment and meal times to specific time zones. Patients with insulin should inform the airline before departure and carry with them a medical certificate (in English) for bringing syringes and needles on board.

Some health hazards from pressure changes during flight :

• Otitis and sinusitis

Passengers with nasal allergies or chronic sinusitis are more prone to have ear and sinus problems because of low humidity in the cabin, changes in cabin pressure during ascent and descent aggravated nasal congestion. Especially during descent, the Eustachian tube tends to collapse in the middle ear, resulting in the characteristic “pop” sensation, difficulty hearing and pain. To avoid ear blockage :

• Jet lag

Trans-meridian flights through multiple time zones on long-haul routes can cause sleeping difficulties stemming from biological clock and circadian rhythm disorder. The main symptoms are sleeping difficulty, tiredness, dizziness, constipation and a decrease in mental and/or physical performance. Elderly passengers, passengers traveling on night flights and eastward tend to be more sensitive to jet lag. To re-synchronize the internal biological clock more easily, some tricks can be used:

Avoid drinking alcohol and caffeinated drinks

Melatonin or short action hypnotics can be used (melatonin is contra-indicated in children, people taking warfarin or those who have epilepsy)

Going to bed one hour earlier and awakening one hour earlier three days before traveling eastward and later if traveling westward

Natural light exposure during day at the new destination will help resynchronization

• Deep vein thrombosis (DVT)

So-called “economy class syndrome” is a condition in which the thrombus develops in deep veins due to long distance flights, variation of cabin atmosphere (decrease in humidity and hypoxia, for example), immobility and dehydration. A dangerous consequence is that DVT can result in a pulmonary embolism. Symptoms of DVT can come late, after flights, indicated by aching or soreness in the calf, swelling in the calf or ankles, slight fever or feeling unwell.

People with the following risk factors should be aware of DVT :

People over 40

Past history of venous thrombosis

Recent surgery especially abdominal, pelvic or leg surgery

Prolonged immobilization

Coagulation problems or increased blood viscosity

Pregnancy or recent delivery

Cancer

Cardiovascular diseases

Estrogen hormone therapy or oral contraception

Cigarettes smokers

Varicose veins

Obesity

Safety precaution to avoid DVT :

Wear loose fitting and comfortable clothing

Wear graduated compression stockings

Keep hydrated by drinking lots of water throughout the flight

Leave the underside of the seat in front of you free to be able to move the legs

Walk often in the cabin

Exercise as recommended in the aircraft

High risk passengers should consult their doctor before travelling for prevention (such as with low molecular weight heparin or aspirin)

On board Medical Assistance

TG like every airline has some capability to render medical care inflight. Cabin crews are well and regularly trained for first aid and cardiopulmonary resuscitation, and they also may ask for assistance from an on-board medical doctor. Medical equipment available includes:

First- aid kits (to used by cabin crew)

Medical kits (one white and one black) are available for on-board medical doctors or with use of defibrillator

Automatic external defibrillator (AED)

Wheelchair (for long distance flight)

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ຂໍ້ແນາະນຳເພືອຄວາມປອດໄພ

Be Careful with Hot Drinks

While en route our flight attendants will provide hot beverage service to passengers. In order to prevent burn injuries from hot liquid spills, we would like the passengers to:

- When a coffee/tea cup is placed on a carry tray, please wait until the flight attendant finishes pouring the hot liquid and then pick up the coffee/tea cup with caution.

- In case of no carry tray in use, the flight attendant will pour the hot liquid into a coffee/tea cup that the passenger holds with a handle. Please wait until he/she finishes pouring before taking it back; otherwise hot liquid may spill out and possibly cause injury.

Lying on the Cabin Floor

Passenger seats on board all THAI aircraft have been designed, in line with standard aviation regulations, to be properly fitted, convenient and secure. In particular on long haul flights, some passengers may prefer to change their position by lying on the cabin floor around seating areas, but this can pose a threat to their own safety. Despite a clean and tidy floor, tiny dust particles in the carpet may cause allergic symptoms, and even affect the respiratory system. Moreover, the on-board oxygen may not be circulated fully and sufficiently down on the floor, causing difficult to breathe, and, upon getting up, the passenger may feel light-headed and dizzy. Most importantly, when lying on the cabin floor contact with the metal parts of the seat and floor can cause severe injury, especially during turbulence.

ຂໍ້ຫ້າມ ແລະ ຄຳແນາະນຳສຳຫລັບຜູ້ປ່ວຍທີ່ເດີນທາງໂດຍເຮືອບິນ

Sick passengers are sensitive to minor changes, therefore medical consultation before travelling is necessary to minimize health risks. Medications must be kept in the hand luggage. Travelers with metallic prosthesis, cardiac pacemaker, internal defibrillator or those who have to carry medical equipment on board must travel with a medical certificate.

Disabled passengers who need assistance during flight must be accompanied and notify in advance for special arrangements by cabin crew.

Passengers with medical conditions not treated and stabilized, or passengers which conditions that can be aggravated during flight, must have medical clearance before flight reservation.

Note: A MEDIF (medical information form) must be filled by treating doctor to inform the details of the medical conditions, and if special equipment such as oxygen, a wheelchair or stretcher is needed. THAI has the right to refuse, delay or ask for changing travel conditions. Travelling by plane is permitted only for treated and stabilized patients.

The following conditions are contra-indicated for air travel :

Infant less than 7 days of age, the cabin atmosphere can cause problem for newborns. MEDIF is needed for premature babies.

Pregnant women : non complicated pregnancy is accepted on board; the conditions depend on the airlines to prevent premature labor on board; caution should be exercised about frequent flying during early weeks because of hypoxia. The conditions for pregnant women are as follows :

Pregnancy more than 28 weeks must have a medical certificate confirming the date of delivery and conditions of pregnancy

Single pregnancy can travel until 36th week for the flight less than 4 hours and 34th weeks for the flight more than 4 hours. The medical certificate with estimate date of delivery and confirmation of a normal pregnancy is needed. 3. Multiple or complicated pregnancy (placenta previa, past history of premature delivery etc.) are relatively contra-indicated for travelling long distance by air, the medical approval from the company is absolutely needed. 4. Pregnancy more than 36 weeks is an absolute contra-indication for travelling by air.

• Patient with cardiovascular and pulmonary diseases

Assure sufficient quantities of cardiac medications for the entire trip, including sublingual nitroglycerin, and keep in carry-on luggage. Keep a separate list of medications including dosing intervals and tablet size in the event that medications are lost. Limit unnecessary ambulation, particularly inflight. The following conditions are not safe for air travel :

Unstable chest pain - Recent myocardial infarction (MI) and congestive heart failure should not fly until at least 6 weeks have passed and they are back to usual daily activities no more chest pain

Coronary artery bypass grafting (CABG) and other chest surgeries should wait until the air is resorbed 2 weeks before air travel because air is transiently introduced into the chest cavity, there is a risk for barotrauma at decreased atmospheric pressure

Uncontrolled heart failure

Untreated hypertension with systolic blood pressure higher than 160 mmHg. No contra-indication to air travel for patients with hypertension as long as it is under reasonable control. Such patients should be reminded to carry their medications onboard

Untreated arrhythmia (heart rhythm must be controlled and on anti coagulant for travelling)

Decompensated valvular diseases

Scuba diving less than 24 hours or decompression sickness

Untreated or unstable pneumothorax

Undrainaged pleural effusion

Asthma, air travel is contra-indicated for those with asthma that is labile, severe, or that has required recent hospitalization. For asthmatics of less severity who are fit to fly, it is imperative that they are reminded to hand-carry on board any vital medication, particularly inhalers for rapid relief of symptoms

Chronic obstructive pulmonary disease (COPD). Patients with chronic bronchitis, interstitial lung disease and emphysema are susceptible to significant inflight hypoxemia, depending on their baseline PaO2. Preflight evaluation of these patients is ability to walk 50 meters or climb stairs without dyspnea and shortness of breath

Uncontrolled respiratory failure

Patient under mechanical ventilation or with the unstable condition for the trip

Active pulmonary infection

Neuromuscular diseases with hypoventilation and require a mechanical ventilation

Pulmonary tuberculosis especially in immunodeficients treated less than 2 weeks

Thoracic surgery less than 3 weeks

Special precaution for the patients with tracheostomy because of low humidity in the cabin

• Central Nervous System Disorders

Uncontrolled epilepsy or the patients undergone for brain surgery with no complications less than 2 weeks. Normally, the passengers with stable epilepsy or after brain surgery may be more prone to seizures during a long flight, mild hypoxia and hyperventilation are known precipitating factors, in addition to the aggravation of fatigue, anxiety and irregular medication. Whilst it would not be appropriate to change medication immediately prior to a trip, consideration should be given to providing extra anti-convulsive medication. If nothing else, the passengers with epilepsy must ensure that they have sufficient medication in their hand baggage for the duration of the flight and also for any unexpected delays

Following a stroke or cerebrovascular accident passengers usually have to wait at least 2 weeks before travel if stable or recovering. For those with cerebral artery insufficiency, hypoxia may lead to problems and supplementary oxygen may be advisable

Patients with accident and brain injury less than 15 days

Untreated brain edema or lumbar puncture less than 1 week

Patients who have recent brain scan with use of contrast media less than 3 days

Psychiatric patients need medical clearance in advance of intended travel. Patients with psychotic disorders who are stabilized on medication and are accompanied by a knowledgeable companion plus suitable sedation may be able to fly

• Gastro-Intestinal Disease :

Passengers may experience abdominal discomfort because of gas expansion in fight.

Patients who have abdominal surgery in which hollow viscus has been sutured are at risk of perforation or hemorrhage as a result of gas expansion at altitude. Air travel should be discouraged for 2 weeks following any abdominal surgical procedure

Travelers with colostomies are not at increased risk during air travel although intestinal distension may increase fecal output. The use of a large colostomy bag is recommended. More frequent changes may be necessary for smaller bags and extra supplies should be carried in the cabin hand baggage

Patients with intestinal occlusion or with hemorrhage from ulcer sites or rupture of esophageal varices. For hemorrhage, travel may be permitted if there is clear endoscopic evidence of healing or wait for 3 weeks and hemoglobin level more than 10 g/dl

Severe gastroenteritis with dehydration

Patients who have gastric or intestinal surgery in the past 7 days

Patients who have a colonoscopy in the past 24 hours

• Deep Vein Thrombosis (DVT):

Passengers are at risk of developing economic class syndrome from cramped seating, inactivity, prolonged immobilization, depletion of body fluids causing increased blood viscosity, poor blood circulation and swelling of feet and legs then a thrombus develops in the deep veins. To reduce the risk while traveling it is recommended to wear comfortable shoes or take shoes off, exercise the calves, mobilize, stretch arms and legs every couple of hours, walk around the cabin, avoid sleeping pills, remain adequately hydrated and avoid excess alcohol.

Severe anemia with hemoglobin less than 10 g/dl. At low oxygen levels in cabin, passengers may experience lightheadedness or even lose consciousness during flight and hemoglobin less than 8.5 g/dl is contra-indicated for air travel

Unstable diabetes must not travel by air. For well controlled diabetes, the first step is to order from the airline, in advance, the appropriate diabetic meal. Diabetic travelers should carry all medications (as well as needles, syringes, blood glucose monitors, sugared snacks, and a device to store needles/lances) in carry-on luggage and not in checked luggage. Journeys may across several time zones. It is recommended to remain on departure time during the flight and attempt to readjust to local time on arrival at destinations

All recent surgery or recent injury, gas trapped within the body will cause problems at altitude

Recent fracture under plaster cast (cast must be split for traveling to avoid compartment syndrome or harmful swelling on long flight)

Severe burn or infected large wounds

Terminal stage of illness which can deteriorate during trip

Precaution for the patients with urinary catheter, balloon must be filled with water, the catheter changed before departure with no sign of urinary tract infection by direct examination and by urine culture

Nut Allergy

Due to the number of passengers on THAI flights, the company cannot guarantee a 100% nut-free environment in its lounges nor aircraft cabins. Nevertheless, if THAI is informed well in advance of a passenger’s medical condition, the company will strive to ensure that each touch point is aware of passenger requirements.

We also highly recommend that you carry your medication and/or medical ID bracelets at all times, as well as alert THAI staff in cases of allergic reaction.

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ຄຳແນາະນຳສຳຫລັບຜູ້ສູງອາຍຸໃນການເດີນທາງໂດຍເຮືອບິນ

Preparation for air travel

For any existing, chronic illness, to ensure that health conditions are safe for the trip, keep any necessary medication in your hand luggage.

Pack appropriate clothing for the destination.

Confirm your health insurance before flying

During flight

Exercise and try to move around in the aircraft to prevent blood clots.

Keep hydrated by drinking a lot of water; avoid alcohol and coffee.

At the destination

Elderly passengers ¬– like small children – are more prone to severe dehydration, therefore they should avoid long term sun exposure.

Prevent constipation by increasing water intake or using laxatives if necessary.

Be mindful of food and water hygiene.

Take adequate rest to adjust to the local time zone.

Keep skin clean to avoid infections.

ການເດີນທາງໂດຍເຮືອບິນກັບຜູ້ໂດຍສານແອນ້ອຍ

- Inform the local reservation & ticketing officers about children’s information for appropriate seating and preparation of facilities on the aircraft

The Bassinet for babies less than 6 months of age, weighing less than 10 kg and not exceeding 62 67 cm in length.

For babies less than 2 years old, an FAA-approved car-seat can be used on the normal paid seat for a child fare.

- Babies and toddlers must be held in the arms during taking off and landing - Prepare adequate clothing to keep the baby warm in the plane - Air travel is not recommended for infants during the first week of life, when a newborn’s body is still adjusting to life outside the uterus and to assure that the child is healthy and free of congenital defects. Healthy infants 7 days of age are acceptable to travel with an adult passenger. - Children with chronic disease may be at risk for hypoxia during flight, and a physician should be consulted before air travel. - Changing cabin pressure cause temporary changes in middle ear pressure, which can result in pain. To minimize this, it is helpful to have a baby nurse a bottle, breast or suck on a pacifier (older children may drink from a cup or chewing gum) particularly during descent. This will help equalize the air pressure in the middle ear. - For children who suffer from motion sickness, medication can be used 30 minutes before departure